Acta anaesthesiologica Sinica最新文献

{"title":"Nitrous oxide suppresses tonic and phasic nociceptive behaviors but not formalin-induced c-Fos expression in the rat spinal cord dorsal horn.","authors":"F. Lin, B. Shyu, J. Shieh, Wei-Zen Sun","doi":"10.6955/AAS.200309.0115","DOIUrl":"https://doi.org/10.6955/AAS.200309.0115","url":null,"abstract":"BACKGROUND\u0000The aim of this study was to investigate the anesthetic and analgesic effects of subanesthetic concentration of nitrous oxide and to compare these effects with halothane and fentanyl.\u0000\u0000\u0000METHODS\u0000The antinociceptive effects were assessed in male Sprague-Dawley rats by behavioral responses to phasic and tonic nociceptive stimulations and biochemical index of pain, formalin-induced Fos-like immunoreactivity (Fos-LI), in spinal cord dorsal horn. Neurological functions (proprioception, mental status and motor function) were monitored to determine whether or not behavioral responses were impaired by anesthetic action of the treatment. Four groups of rats treated with: (1) saline, (2) 75% nitrous oxide (0.5 MAC), (3) 0.5% halothane (0.5 MAC) and (4) fentanyl 100 micrograms/kg were subject either to graded intensity of CO2 laser stimulation (phasic pain) or s.c. injection of 50 microliters 2.5% formalin (tonic pain) in two separate studies. All rats in the tonic pain study were killed for immunohistochemistry at 60 min after formalin injection. Maximal counts of Fos-LI labelled neurons in rat spinal cord dorsal horn were compared according to the laminar distribution.\u0000\u0000\u0000RESULTS\u0000We found that all rats exhibited normal righting reflexes regardless of whatever treatment. Nitrous oxide and halothane greatly impaired mental status and motor function, indicating that both agents could induce a modest degree of sedation and paresis at subanesthetic concentrations. Fentanyl increased the threshold level to noxious thermal stimulation, and reduced the formalin-induced licking/biting behaviors and the number of Fos-LI labelled neurons which are predominantly found in the neck of the dorsal horn. Nitrous oxide and halothane increased the thermal nociceptive threshold, suppressed licking/biting behavior in both early and late phases of the formalin test. Unlike fentanyl, nitrous oxide and halothane failed to suppress c-fos expression. The extent and pattern of nitrous oxide-induced antinociception was identical to halothane, which is known to have little or no analgesic effect. The lack of attenuated biochemical response to tonic pain stimulation may suggest that nitrous oxide fails to suppress spinal sensitization despite its potent inhibition on behavioral hyperalgesia.\u0000\u0000\u0000CONCLUSIONS\u0000These findings suggest that, at the spinal level, subanesthetic concentration of nitrous oxide greatly attenuates nociceptive behaviors mainly due to a non-selective suppression of behavioral responses that are commonly associated with inhalation anesthetic drugs.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3 1","pages":"115-23"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal anesthesia with two different dosages of 0.75% glucose-free ropivacaine: a comparison of efficacy and safety in Chinese parturients undergoing cesarean section.","authors":"John On-Nin Wong,&nbsp;Thomas Dou-Moo Tan,&nbsp;Pak-On Leung,&nbsp;Kin-Fui Tseng,&nbsp;Ning-Wei Cheu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.</p><p><strong>Methods: </strong>In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine as opposed to 3 ml in Group B. Sensory and motor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motor block and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.</p><p><strong>Results: </strong>Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 +/- 6.7 min vs. 2.3 +/- 9.8 min; maximum cephalic spread was T3-4 (C3-T7) vs. T3 (C2-T8); maximum number of blocked segments was 20.7 +/- 3.5 vs. 20.2 +/- 3.4; time to maximum sensory block 15.4 +/- 5.5 min vs. 20.3 +/- 15.1 min; time for regression to L3 was 200.8 +/- 59.5 min vs. 215.0 +/- 37.6 min and time for complete recovery of motor block 208.5 +/- 55.5 min vs. 226.5 +/- 461. min. Group B had a significantly faster onset time for complete motor block (P < 0.05) 15.4 +/- 5.6 min vs. 10.4 +/- 4.7 min. Moreover, there were no significant differences in global hemodynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the beginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.</p><p><strong>Conclusions: </strong>We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.</p>","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3","pages":"131-8"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24061975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden complete obstruction of breathing circuit during postural change upon completion of thoracic spinal surgery in a pediatric patient.","authors":"Ying-Ming Wang, Cheng-Show Chen, Nien-Chun Chung, Xuan-De Ye, Kang Liu","doi":"10.6955/AAS.200309.0145","DOIUrl":"https://doi.org/10.6955/AAS.200309.0145","url":null,"abstract":"Positioning patients during the perioperative period is a common event to anesthesiologists. A variety of complications may arise during this cumbrous moment. We describe a rare circumstance that we came across immediately after changing the posture of a pediatric patient at the end of thoracic spinal surgery. A total occlusion of the combined heat-moisture exchanger (HME) and bacterial/viral filter was responsible for breathing circuit obstruction. The use of the combined HME and bacterial/viral filter is not entirely riskless during general anesthesia.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3 1","pages":"145-8"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal anesthesia with two different dosages of 0.75% glucose-free ropivacaine: a comparison of efficacy and safety in Chinese parturients undergoing cesarean section.","authors":"J. O. Wong, T. D. Tan, P. Leung, K. Tseng, Ning-Wei Cheu","doi":"10.6955/AAS.200309.0131","DOIUrl":"https://doi.org/10.6955/AAS.200309.0131","url":null,"abstract":"BACKGROUND\u0000We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.\u0000\u0000\u0000METHODS\u0000In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine as opposed to 3 ml in Group B. Sensory and motor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motor block and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.\u0000\u0000\u0000RESULTS\u0000Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 +/- 6.7 min vs. 2.3 +/- 9.8 min; maximum cephalic spread was T3-4 (C3-T7) vs. T3 (C2-T8); maximum number of blocked segments was 20.7 +/- 3.5 vs. 20.2 +/- 3.4; time to maximum sensory block 15.4 +/- 5.5 min vs. 20.3 +/- 15.1 min; time for regression to L3 was 200.8 +/- 59.5 min vs. 215.0 +/- 37.6 min and time for complete recovery of motor block 208.5 +/- 55.5 min vs. 226.5 +/- 461. min. Group B had a significantly faster onset time for complete motor block (P < 0.05) 15.4 +/- 5.6 min vs. 10.4 +/- 4.7 min. Moreover, there were no significant differences in global hemodynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the beginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.\u0000\u0000\u0000CONCLUSIONS\u0000We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3 1","pages":"131-8"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient safety during anesthesia: the breathing circuit system.","authors":"Chih-Shung Wong","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3","pages":"97-8"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24062041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General anesthesia for patients with automatic implantable cardioverter defibrillator in place--a case report.","authors":"M. Chan, Yen-Chin Liu, Ben-Shiang Deng, Kang Liu","doi":"10.6955/AAS.200309.0159","DOIUrl":"https://doi.org/10.6955/AAS.200309.0159","url":null,"abstract":"Automatic implantable cardioverter defibrillator (AICD) was commercially available for use in patients with malignant ventricular tachycardia and ventricular fibrillation since its meeting with FDA approval in 1985. The number of AICD implantation has increased year by year worldwide. It was allowed to be used in clinical setting in Taiwan by the Department of Health in April 1997. Physicians may come across patients with an implanted AICD undergoing surgery unrelated to cardiac issues more frequently. It is also a new challenge to anesthesiologists who must make pre-operative evaluation, maintenance during operative period and post-operative re-evaluation of the AICD function. We bring forward here for discussion a 72-year-old male patient who underwent non-cardiac surgery with AICD implantation under general anesthesia. The anesthetic precautions of patients with the device are also touched.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3 1","pages":"159-62"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The antinociceptive effect of a long-acting nalbuphine preparation in rabbits.","authors":"S. Ho, Jhi-Joung Wang, O. Hu, J. Tzeng, Kuo-Sheng Liu, Yu-Wen Chen","doi":"10.6955/AAS.200309.0099","DOIUrl":"https://doi.org/10.6955/AAS.200309.0099","url":null,"abstract":"BACKGROUND\u0000An analgesic with a long-lasting effect is particularly desirable to patients suffering from long-standing pain. The aim of this study was to evaluate the antinociceptive effect and duration of action of an oily dosage form of nalbuphine base and to see whether its effect could last longer compared with nalbuphine HCl.\u0000\u0000\u0000METHODS\u0000Male New Zealand White rabbits (n = 6 in each group) were used. Two studies were carried out. In study 1, we evaluated the antinociceptive effect of intramuscular nalbuphine HCl (in saline) with dosages of 25, 50, and 100 mumol/kg. In study 2, we evaluated the antinociceptive effects of intramuscular nalbuphine base (in sesame oil) with dosages of 100, 200, and 400 mumol/kg. In these studies, the vehicles (saline or sesame oil) were used as controls. A paw pressure test was used to detect the antinociceptive effect of the testing drugs.\u0000\u0000\u0000RESULTS\u0000We found that nalbuphine HCl 25, 50 and 100 mumol/kg produced a dose-related antinociceptive effect with durations of action of 1, 1, and 1.3 h, respectively. Nalbuphine base 100, 200 and 400 mumol/kg also produced a dose-related antinociceptive effect but with longer durations of action of 8, 24, and 48 h, respectively. On an equimolar basis (100 mumol/kg), nalbuphine base produced a 6-fold increase in the duration of action than did nalbuphine HCl.\u0000\u0000\u0000CONCLUSIONS\u0000We conclude that intramuscular nalbuphine base produced a relatively longer duration of action than did intramuscular nalbuphine HCl.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 3 1","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lidocaine: the optimal timing of intravenous administration in attenuation of increase of intraocular pressure during tracheal intubation.","authors":"Yi-Ming Wang,&nbsp;Kwan-Chi Chung,&nbsp;Hsiao-Feng Lu,&nbsp;Yu-Wei Huang,&nbsp;Kun-Chen Lin,&nbsp;Lin-Cheng Yang,&nbsp;Chung-Ren Lin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This study was designed to examine the optimal timing of intravenous lidocaine in attenuation of increase of intraocular pressure in response to laryngoscopy and tracheal intubation during induction of anesthesia.</p><p><strong>Methods: </strong>One hundred and thirty five adult patients of ASA class I, aged between 20-35 years, undergoing surgical procedures irrelevant to ophthalmology were enrolled for study. Patients were randomly assigned to one of five groups. In group II, III, IV and V the patients received intravenous injection of lidocaine (2 mg/kg), 1, 3, 5, 10 min before tracheal intubation, respectively. Group I in which patients did not receive lidocaine served as the control group.</p><p><strong>Results: </strong>In patients of groups I, IV and V, the intraocular pressure increased significantly after intubation, whereas in those of groups II and III, the intraocular pressure did not. All patients in the five groups showed concomitantly a surge of blood pressure, but the magnitude of increase was smallest in group III in comparison with the other groups. The values of systolic and diastolic pressures 1 min after intubation were significantly less in groups III and IV than in the control group.</p><p><strong>Conclusions: </strong>In healthy patients aged between 20 and 35 the most optimal time of administration of intravenous lidocaine to attenuate the increase of intraocular pressure seemed to be the space between 1 to 3 min before laryngoscopy and tracheal intubation.</p>","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 2","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22542559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed diagnosis of esophageal perforation following intraoperative transesophageal echocardiography during valvular replacement--a case report.","authors":"Yin-Yi Han, Ya-Jung Cheng, W. Liao, W. Ko, S. Tsai","doi":"10.6955/AAS.200306.0081","DOIUrl":"https://doi.org/10.6955/AAS.200306.0081","url":null,"abstract":"A 62 year-old man sustained esophageal perforation following intra-operative transesophageal echocardiography (TEE) in a valvular replacement surgery. Septic shock developed on the 12th postoperative day (POD) and the esophageal perforation was diagnosed with chest CT. Emergent operation together with intensive care saved the patient's life. We speculate that the mechanism of perforation was not due to manipulation of the probe, but rather due to ischemia of the esophagus resulting from the combination of probe compression, non-pulsatile flow and the distension of the atria during a lengthy procedure. It is advisable that in patients with operative risk factors, such as distension of atria, long cardiac procedure and likely ischemia of organs due to cardiopulmonary bypass, the monitoring probe of TEE should not constantly rest in the esophagus and be withdrawn when it is idle or not in actual use. In addition, if resistance has been met during the intraoperative manipulation of the probe in a patient without previous history of esophageal disease, perforation might suspected if he or she sustains postoperative fever with positive chest X-ray findings.","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 2 1","pages":"81-4"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71333771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior vena cava tear during posterior spinal fusion surgery.","authors":"Yu-Ren Wang,&nbsp;Yen-Chin Liu,&nbsp;Nien-Chun Chung,&nbsp;Su-Zhen Wu,&nbsp;Ming-Shan Chen,&nbsp;Xuan-De Ye,&nbsp;Kang Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inferior vena cava tear is a rare but potentially lethal event associated with spinal surgery. Early recognition and repair are mandatory to minimize morbidity and mortality. Here we report a case of inferior vena cava tear which occurred during posterior spinal fusion surgery. Without marked bleeding from the surgical field, the patient was suddenly seized with a profound shock. Abdominal distension was found after resumption of the supine position from prone. Emergent exploratory laparotomy disclosed inferior vena cava tear. After repairing of the torn vessel, the patient was transferred to ICU. Unfortunately, patient expired two weeks later due to multiple-organ failure.</p>","PeriodicalId":79312,"journal":{"name":"Acta anaesthesiologica Sinica","volume":"41 2","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"2003-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22542563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}